Despite a large number of public health, community, school, and other campaigns, a large percentage of the adult population still smoke. The elderly smoker has been largely ignored in the literature, with most smoking cessation efficacy studies (both with and without nicotine replacement) excluding the older adults from participation. However, smoking cessation is one of the few risk factors that is known to reduce mortality/morbidity regardless of age (Mattson et al., 1987). There are significant numbers of older adult smokers and available data suggests that cessation rates, with assistance, are likely to be relatively high in this population. With this introduction, we propose the following Specific Aims: (1) To recruit a cohort of approximately 450 older smokers (ages 65 and up) in primary care settings and randomize these subjects to one of the following: (a) Physician Advice to Stop Smoking plus Self Help Materials; (b) Physician Advice plus Comprehensive Behavioral Treatment/NRT (Nicotine Replacement Therapy) Intervention; and (c) Physician Advice plus Elderly Targeted Comprehensive Behavioral/NRT Program. (2) To determine both short-(test, 6-month follow-up)and long-term (12-month follow-up) cessation rates in the three conditions. We also plan to evaluate long-term changes (12 months) in quality of life and sick/hospital days in both a controlled fashion (by condition assessment) and in a correlational manner (those who are successful in long-term cessation).